Dr. Meryl Nass, an internal medicine specialist at Mount Desert Island Hospital’s Cooper Gilmore Health Center, first became interested in anthrax in the late 1980s. As she became more involved in anthrax research, traveling to Zimbabwe to investigate an anthrax epidemic that occurred in the late 1970s, Nass became acquainted with Bruce Ivins, one of the federal government’s leading anthrax vaccine researchers. When Ivins committed suicide on July 29, 2008, and was subsequently named by the FBI as the culprit of the 2001 anthrax attacks, Nass started blogging about the case at anthraxvaccine.blogspot.com. Since then, Nass has helped push the news media toward taking a more critical look at the FBI’s case. She has been quoted in the New York Times, the Washington Post, and the Wall Street Journal as an anthrax expert, and has testified before the Senate and the House of Representatives on anthrax and other health and bioterrorism issues. A variety of news organizations have now editorialized in favor of an independent investigation of the case, and in February, the National Academy of Sciences determined that the scientific evidence in the FBI’s case was not conclusive, further undermining the investigation, which was one of the largest in the bureau’s history.

BHT: How did you get involved in this whole issue?

MN: That’s such a long story…I knew a lot about anthrax. I had already done a lot of work on anthrax starting in 1988 or 1989, and so when the letters were sent, you may recall that people had a lot of questions about how to deal with them. The public. And there were problems with the spokespeople from CDC [Centers for Disease Control and Prevention] and HHS [Department of Human Health and Services]…There were a lot of changes in who was going to be the spokesperson and there were a lot of issues about who was responsible for the investigation. People got changed several times early on, and media were calling me for interviews because I was already known to do some work in anthrax. So I started posting answers to queries on my website at that time. I made suggestions about how one might mitigate the problem and how individuals would respond and later talked about doing investigating and that sort of thing, and even was calling people I knew at [U.S. Army Medical Command installation] Fort Detrick to get more information when I had a particular question. So anyway I did that. That was it. I wasn’t investigating who sent the letters at all. I don’t have any forensic training. I only know about anthrax. But I did know most of the people who have been in the field of anthrax for a long time because it’s a very small number of people.

BHT: About how many?

MN: When I went to my first international anthrax conference in 1998, there were probably between 100 and 150 people there. Maybe 200 at the most. In those days, there weren’t a lot of people.

BHT: And how would you describe your role in that small field?

MN: I started out as being a layperson, who — it’s such a long story — I was a member of Physicians for Social Responsibility. I was interested in arms control. I lived in Amherst, Mass, and there were demonstrations in Amherst by students who discovered that UMass [University of Massachusetts] had Pentagon contracts for doing anthrax research, and I wound up being asked to read the contract and report back to my Physicians for Social Responsibility group. This was back in 1988 or 1989. So it turned out that the contract, which was named “Studies for an improved anthrax vaccine,” actually had nothing to do with developing vaccines but was about a sort of rudimentary form of genetic engineering of anthrax. And so the fact that there was a contract that was sort of obfuscating by name what it was actually doing I found interesting, and I thought I better just look into this a little more…I just went through a lot of materials and discovered two things that I thought were important at the time, one, being that although the army and the federal government had a policy on what research they felt they could legally do because there was an international treaty banning biological warfare that’s sort of specific about the kinds of peaceful, protective, defensive research that could be done and what kinds of research were prohibited by international treaty, that the U.S. could be construed to be doing research that its own mission statement and the international treaty said it shouldn’t be doing. A.

And B, I decided if everyone was so concerned about anthrax I would look at recent anthrax epidemics and would see what they looked like. So I did that, I went back 15 years, and I pulled all the articles on anthrax epidemics and read them, and discovered that one in Zimbabwe had entirely different characteristics than all the others. And it became obvious to me in early 1989, that this was probably due to biological warfare, and I was a physician, but I wasn’t an infectious disease doctor, or bio-warfare expert by any means, and I decided that I would just read some more about this, and if it was possible I’d publish a paper on it, because it was important in terms of arms control that people become aware of how these things have been used in the real world, and so over a period of three years I did a lot of reading, I did research, I went to Zimbabwe…Anyway, I wrote what turned out to be a very important paper published in 1992 showing that the Zimbabwe epidemic was very different from normal epidemics and was almost certainly due to biological warfare, and the other thing this paper did was sort of develop a model for how one might analyze suspect epidemics. Having done that, all that work, real researchers knew of this work, because it was fairly high quality. It was as if it was written by somebody who knew a lot about anthrax…

In 1997, it was announced that the U.S. was going to immunize all of its troops for anthrax…and that this would be the lead-in to vaccinating all their troops against a number of biological warfare agents. But they were going to start with anthrax because anthrax was already licensed and these other vaccines were still in development, except for smallpox, which was also licensed. I wrote a very short paper, which was just to a Listserv called ProMED-mail, which discussed epidemics, and I pointed out in this short paper with five or six references that there was no published evidence for efficacy or safety for anthrax vaccine, and before the government started up a wholesale program to vaccinate 2.5 million people, some of this data needed to be generated or published. That little nothing got cited in the Lancet, one of the biggest medical journals in the world.

After that, somebody who read that asked me to write a review article on anthrax vaccines, which I did, which was published in the beginning of 1999, and people started calling me. If they went on the computer and typed in anthrax vaccine, my name would pop up. So, I got a lot of people calling me telling me they were sick from anthrax vaccine. The first 50 or 100, I told them I didn’t think that was probably accurate — that the symptoms didn’t seem to be vaccine related, didn’t resemble symptoms for other vaccines. And then after I got hundreds of people calling me I realized that there was really something different going on with anthrax vaccine, and I worked for a number of years trying to get that vaccine investigated properly and stopped until we had a better version. So I wound up testifying before congressional committees and things like this, and then later I had to testify to congressional committees on Gulf War Syndrome and bioterrorism. Anyway, that’s sort of what happened to me. One thing lead to another.

So then the anthrax letters, I really didn’t pay attention to who sent them until Aug. 1, 2008, when the FBI announced that this fellow who was actually an acquaintance-slash-friend of mine had committed suicide, and they said he was the person who had done it. A lot of information that was provided to the public seemed to me to be inaccurate, exaggerated and did not speak to the heart of the issue, did not provide the evidence that he had done it, and so I started just writing on my blog about this, and people picked it up. So I’ve done a lot of interviews about the anthrax letters, too.

BHT: So what was your connection to Ivins?

MN: Well, Ivins was the main anthrax vaccine researcher at Fort Detrick, so I knew his work. But actually we had met at a conference on biological defense in 1991. We both attended this conference in Baltimore, I think it was three days, and we happened to sit next to each other. And we started talking, and we became friendly, and I told him about the research I was in the process of doing on Zimbabwe, and he sent me some materials that were relevant, and then later when I saw him at conferences, and was working on anthrax vaccine, he again would give me information that he thought was relevant, and we’d talk about our respective work. You know, I didn’t know him well, I just saw him at conferences, but we had known each other over a number of years.

BHT: On your blog, right after the FBI sort of pinned him as the guy, right after he killed himself, you clearly said, ‘He did not do it.’

MN: I don’t know about that. You’ll have to show me what I wrote then. What I remember now is thinking, ‘They’re making a ridiculous case. They have provided a lot of completely circumstantial and in many cases irrelevant pieces of information, and have not demonstrated’ — If you speak to anybody who knows about this case, you will learn that there is no physical evidence linking Ivins to the anthrax letters. There were hundreds of people that had access to Ivins’ flask, and that’s been well-documented in the media. Basically, the FBI’s entire case rests on the fact that Ivins was a peculiar individual and had a lot of hang-ups, and he happened to have a flask that most likely served as the progenitor material for anthrax that was grown and then put into the letters. But he had also shared that material with several other labs, and so any of them could also have supplied the progenitor material. So, basically that’s the FBI’s entire case, and it’s not very satisfying for anyone who has looked into it.

BHT: What is the role of this company Emergent BioSolutions — formerly known as BioPort — in this whole story?

MN: I probably don’t have all the pieces. But there’s a fellow named Ibrahim El-Hibri…He and his son somehow purchased a lot of anthrax vaccine at the time of the Gulf War from the U.K., and sold it to Saudi Arabia at 100 times mark-up, and I got this from the person who was in charge of the bio-defense program in the U.K., so that’s real. So they were investors, they were probably slightly crooked, slightly sleazy…so they got into bio-defense, and apparently Admiral William Crowe, who was chairman of the joint chiefs at one point and then became the U.S. Ambassador to the U.K., was friendly with Ibrahim El-Hibri — supposedly he suggested to the El-Hibris that they may want to purchase bio-defense vaccine manufacturers, or maybe the anthrax company. And the company that made anthrax vaccine in the U.S. for many years was actually part of the Michigan Department of Health, and they had not been keeping it up, it had not been making too much money, and it had been failing FDA [Food and Drug Administration] inspections. So FDA was going to shut them down unless they made expensive renovations…

In any event, Michigan was making all the vaccine that was being used by people like Ivins to do animal testing. So they were the only licensed manufacturer in the United States of human anthrax vaccine. And so they were maybe going to close…FDA issued a notice of intent to revoke the licenses for the plant in 1996, 1997. So, the El-Hibris got in there and made a deal where they put $3.25 million dollars down…and bought the plant in September of 1998, and subsequently have spent a lot of money on lobbying, and have managed to sell large stockpiles to the Department of Health and Human Services for civilians in the event of an anthrax attack, as well as to the Defense Department. On their $3.25 million dollar investment, they’ve made between $500 million and a billion dollars.

BHT: What percentage of the contracts that have gone to bioterrorism related issues have gone to this company since 2001?

MN: It’s very hard to say. Because there are a lot of different contracts, and the contracts are often for variable amounts depending on what the government wants, and depending on if they meet certain benchmarks at the time. But they have sold over 25 million doses to HHS at about $25 a dose, so that’s about $625 million dollars…And they’ve sold the military I’m not sure how many doses. But in 1997, when they were going to shut the plant down, it was $2 and change a dose…They’ve made way too much profit on this vaccine, which is very inexpensive to manufacture…But the day before they bought it, the Army gave them free indemnification, which meant that were there any lawsuits, then the Army would pay. The manufacturer would not be responsible.

BHT: So there’s this compulsory program for anthrax vaccine for service members. In your testimony, to Congress you’ve talked about the effect of this vaccine, and how soldiers have not wanted to take it. What is this vaccine doing to these soldiers and why are they being compelled to take it?

MN: Oddly enough, and I wasn’t really expecting this at all, when I started being concerned about the vaccine, it seems that the most common serious side effect is something like Gulf War Syndrome, which is something like fibromyalgia, or chronic fatigue syndrome. The way Gulf War Syndrome is defined by the CDC is pain, cognitive or emotional impairment and fatigue. Any two of those three, basically, thousands of people who have gotten sick from anthrax vaccine have developed this kind of illness. You don’t have to have had anthrax vaccine to get this kind of illness. People who never got anthrax vaccine can have it. People who went to the Gulf and were not vaccinated can have it. The efficacy for humans of this vaccine is just unclear. The safety is also unclear, because there haven’t been any good studies to indicate how much of a concern my concerns are. Do these side effects happen in 1 percent of troops, in .01 percent of troops, in 10 percent of troops? We don’t know. There’s no data. I have lots of anecdotal data, where some sergeant went and queried all the people in his platoon who got sick, so I’ve heard several thousand stories of illness, but I don’t have good data.

BHT: Is this compulsory vaccination program for soldiers still ongoing?

MN: Yes. It’s been much easier to avoid getting other vaccines, except smallpox. For civilians, there are three potential ways to avoid vaccines. There’s a philosophical exemption, there’s a medical exemption and there’s just refusal. For soldiers, there are those similar ways to avoid vaccination, and it’s not that hard to get one of those waivers, but for anthrax vaccine and smallpox vaccine it’s very hard to get a waiver, unless you’ve already gotten sick from the vaccine and you can maybe get a waiver for more doses.

BHT: Do you think anthrax is an important enough threat for the amount of resources that have been devoted to it? What was it like before 2001 when no one had heard of this?

MN: Then, there were the 150 people in the world. That was an international conference, including people from Russia, China, Germany, France, Canada. There was very little attention devoted. As I said, the vaccine probably wasn’t very good, because we don’t have any data really to support its use. It made sense to do more research. Ivins was basically almost it in the United States for anthrax vaccine research. Because those conferences weren’t anthrax vaccine conferences, those were anthrax conferences. He was the vaccine guy. He was the top vaccine guy, and other people who worked on anthrax worked on other aspects of anthrax.

BHT: What was his position on the vaccine owned by Emergent BioSolutions?

MN: I never got a quote from him. I don’t know what he thought of it.

BHT: What’s your hunch about what actually went on with these letters?

MN: Well, it’s not a hunch. Let me just back up. Two things. My job is internal medicine, and that means I have to make diagnoses, that’s mostly what I do, is figure out what’s wrong with people. So I’m used to — for 30 years that I’ve been a doctor — I’m used to gathering bits of information that are incomplete and trying to make suppositions about what’s going on. So for the anthrax letters, it seemed that they were probably not written by an Arab. That if the person who wrote them wanted to kill people they wouldn’t have said, ‘This is anthrax, take penicillin.’ At the same time, the anthrax was highly virulent that was used, so I would say that the person or persons who sent the letters were aware that there might be deaths, and accepted that. I would say that the anthrax vaccine program was likely to end. I have seen a draft report that was going around the Pentagon suggesting that mandatory anthrax vaccinations be stopped. At the same time, there was a good possibility that the Patriot Act was not going to be passed. I think Leahy or Daschle were not happy with it. And we know from Paul O’Neill who was [George W.] Bush’s first treasury secretary, that when he first started going to meetings of the Cabinet, he learned that the Bush administration was very interested in being involved in a war with Iraq. This was before 9/11. So, putting this kind of information together, it seems that the anthrax letters, and particularly since the anthrax in them probably had as its progenitor a U.S. Army laboratory, that this was something like the Tonkin Gulf incident, which could have provided ammunition for us to attack Iraq, even if though there was no other evidence that Iraq had been involved with 9/11, and also helped push the Patriot Act forward, and helped encourage the spending of money for bioterrorism, because when 9/11 was only airplanes hitting buildings, why would you spend money on bioterrorism after that? So those are things that certainly happened afterward that were helped along by the letters, and whether the person or persons who sent the letters had that in mind, I can’t say. But people who wanted those things to happen may have had a motive.